HEALTHsuite Mercato Features List

HEALTHsuite Mercato

Healthcare payer software and services

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HEALTHsuite Mercato Feature Summary

  • Member management
  • Group administration
  • Eligibility / enrollment
  • Benefit administration
  • Premium billing
  • Network management
  • Provider contracting
  • Provider credentialing
  • Provider reimbursement
  • Automated repricing
  • UM & med. management
  • Referrals
  • Authorizations
  • Pre-certifications
  • Care management
  • Claims adjudication
  • Encounter processing
  • Capitation
  • Subrogation
  • Overpayment recovery
  • Customer service
  • Fulfillment
  • Data warehouse
  • EDI interfaces
  • Web portals
  • HIPAA compliance
  • Medicaid administration
  • Enrollment of Medicaid members
  • Verify data
  • PCP auto assignment
  • Supports individual beneficiaries
  • Correspondence
  • Cost containment tools
  • CMS application / interface processing
  • CMS letters, ID cards and fulfillment packages
  • Multi-cultural / Multi language
  • Rules based processing
  • Automated workflow
  • Dual eligible processing

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